Intranasal anesthetic effects of lidocaine and tetracaine compared

The quality of nasal anesthesia obtained with two local anesthetic solutions (2% lidocaine in oxymetazoline and 1% tetracaine in oxymetazoline) was evaluated in this double-blind, randomized study. Each local anesthetic mixture was applied to the nasal septum of healthy volunteers with medication-soaked pledgets. Measurements of anesthetic effect (sensation threshold and pain perception) were made with Semmes-Weinstein monofilaments (North Coast Medical, San Jose, Calif.). Measurements were performed before local anesthetic application and at 10 and 70 minutes after local anesthetic application. Subjects had greater increases in sensation threshold with tetracaine than with lidocaine at both 10 and 70 minutes (p = 0.0005 and p = 0.0001, respectively). Subjects had greater decreases in pain perception with tetracaine than with lidocaine at both time intervals (p = 0.0003 and p < 0.0001, respectively). Tetracaine mixed with oxymetazoline appears to be a superior topical anesthetic for nasal procedures.